うっ血性心不全:ACE阻害剤+ARB併用 v ACE阻害剤単独 :併用に一部効果 入院に減少効果認める
2010年 04月 06日
今回は、うっ血性心不全を対象として、ACE阻害剤+ARB併用 v ACE阻害剤単独比較・・・
ARBs+ACE阻害剤併用は、ACE阻害剤単独よりうっ血性心不全患者の入院を減少させるが、全原因死亡率・全原因入院を減少させず、副事象と相関する。
故に、現行のガイドラインでは、腎機能悪化や症候性低血圧の有無を厳格に監視するという前提において、ACE阻害剤治療患者の症状残存患者に改善をもたらす可能性はある。
Meta-Analysis of Combined Therapy with Angiotensin Receptor Antagonists versus ACE Inhibitors Alone in Patients with Heart Failure
PLoS ONE - Cardiovascular Disorders, 04/05/10
Mortality and cardiovascular outcomes in randomized controlled trials comparing angiotensin receptor antagonists and ACE inhibitors versus ACE inhibitors alone in patients with heart failure.
Adverse effects in randomized controlled trials comparing angiotensin receptor antagonists and ACE inhibitors versus ACE inhibitors alone in patients with heart failure.
Table 3. Co-medication in randomized controlled trials comparing combination therapy with angiotensin II receptor antagonists and angiotensin-converting enzyme inhibitor therapy versus ACE inhibitor therapy alone in patients with congestive heart failure.
Table 4. Number of events in randomized controlled trials comparing combination therapy with angiotensin II receptor antagonists and angiotensin-converting enzyme inhibitor therapy versus ACE inhibitor alone in patients with congestive heart failure.
by internalmedicine | 2010-04-06 08:31 | 動脈硬化/循環器